Breastfeeding Difficulty

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Feeding as an infant is a complex activity coordinating the rhythmic processes of sucking, swallowing, and breathing. The ability to suckle in a newborn can be impaired to due to neurological immaturity (gestational age) or mild to severe neurological or musculoskeletal problems that may be caused by:

1. Injury (traction/manipulation/intervention either manually, forceps or vacuum suction)
2. Asphyxiation (premature placental separation, cord wrap, etc.)
3. Congenital deformities such as high palate, cleft palate, ankyloglossia/tongue tie or anatomically short tongue.
4. A genetic developmental disorder
5. Birth-related pharmacological suppression by drugs administered to mother during childbirth (IV fluids, etc.)
6. Invasive procedures to clear meconium, gastric lavage, or insertion of an airway which could result in oral aversion

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As a chiropractor, we work with many of the biomechanical and neuromuscular problems that can lead to painful latch, difficulty sucking, clicking with feeding, increased air intake, difficulty latching on one side or preference to feeding one side vs the other, etc. Often chiropractic care or body work for infants is recommended to mothers as a gentle and safe way to address these issues. If you are struggling with anything related to breastfeeding or infant latch, contact your chiropractor to learn more! They will often have a wide list of resources and information to share with you.

Biomechanical or neuromuscular problems that can occur:

• Decreased range of motion of the jaw preventing them from opening their mouth wide enough to encompass the nipple and areola
• Decreased range of motion in the neck which controls their ability to position themselves comfortably at the breast
• Neurological deficit manifesting a lack of suckling or rooting reflexes
• Ineffective latch due to altered lip or tongue action
• Impaired respiration due to restriction in the thoracic excursion or diaphragmatic action
• Rapid milk ejection reflex or overabundant milk supple which might result in compensatory muscle actions such as clenching to modulate milk flow

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Disclaimer: The advice provided in this article is for information purposes only. It is meant to augment and not replace consultation with a licensed healthcare provider. Consultation with a Chiropractor or other primary care provider is recommended for anyone suffering from a health problem.  ​
References
1.  Goldfield EC, Richardson MJ, Lee KG, Margetts S: Coordination of sucking, swallowing, and breathing and oxygen saturation during early infant breast-feeding and bottle-feeding. Pediatr Res. 2006, 60: 450-455. 10.1203/01.pdr.0000238378.24238.9d.
2. Glass RP, Wolf LS: Incoordination of sucking/swallowing, and breathing as an etiology for breastfeeding difficulty. J Hum Lact October 1994; 185-189.
3. Vallone, S. H. A. R. O. N. (2004). Chiropractic evaluation and treatment of musculoskeletal dysfunction in infants demonstrating difficulty breastfeeding. J Clin Chiropr Ped, 6(1), 349-366.
4. Hawk, C., Minkalis, A., Webb, C., Hogan, O., & Vallone, S. (2018). Manual interventions for musculoskeletal factors in infants with suboptimal breastfeeding: a scoping review. Journal of Evidence-Based Integrative Medicine, 23, 2515690X18816971.
5. Miller, J. E., Miller, L., Sulesund, A. K., & Yevtushenko, A. (2009). Contribution of chiropractic therapy to resolving suboptimal breastfeeding: a case series of 114 infants. Journal of manipulative and physiological therapeutics, 32(8), 670-674.

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